Common Signs a Herpes Infection Has Returned
Recurrence of Symptoms
During the first outbreak of herpes symptoms, the virus travels to nerves that are near the spine. The virus remains inside the nerve cells in a latent or dormant state. While the virus is dormant, a person has no symptoms.
Periodically, the herpes virus becomes active once again, leading either to a recurrent herpes outbreak or to subclinical shedding of the virus. About 90 percent of people with genital herpes caused by HSV-2 will have a recurrence during the first year (the average number of outbreaks is four). About 55 percent of people infected with HSV-1 will have a recurrence of genital herpes during the first year (the average number of outbreaks is less than one). Over time, these recurrences usually decrease in frequency.
Recurrences are generally much milder than the first outbreak of genital herpes and typically last one to two weeks. Symptoms with recurrent infections might include:
- Vaginal discharge
- A burning feeling or pain in the genital or anal area.
Fever, headache, muscle aches, painful or difficult urination, vaginal discharge, and swollen glands in the groin area are less common with a herpes recurrence than with the initial outbreak. Some people experience red bumps that become blisters and then open sores, as with the first episode of genital herpes. However, in recurrent outbreaks, there are usually fewer lesions and they don't last as long as the first outbreak; pain usually lasts for three to five days, and healing usually occurs in 10 to 14 days.
Recurrent lesions can occur anywhere on or near the genitals, but the most common sites are:
- The penis in men
- Near the vaginal opening or on the labia in women
- Near the anus or on the buttocks of either men or women.
Recurrent outbreaks usually appear at the same location every time.
Some people report that stress, other illness, or menstruation bring on an outbreak of genital herpes. However, research indicates that these factors, in fact, have little effect; recurrent outbreaks probably occur randomly. In any case, recurrent episodes usually are not predictable.
Sometimes, the virus can become active but not cause any visible sores or symptoms. During these times, small amounts of the virus may be shed at or near places of the first infection in fluids from the mouth, penis, vagina, or from barely noticeable sores. This is called asymptomatic (without symptoms) shedding. Even though you are not aware of the shedding, you can infect a sexual partner during this time. Asymptomatic shedding is an important factor in the spread of herpes.